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NEAC Advice on Ethical Issues in Elective Services

In September 2006 the National Ethics Advisory Committee - Kāhui Matatika o te Motu (NEAC) provided its advice on ethical issues in elective services to the Minister of Health. The Committee took a whole-of-system approach to this work, considering the overall design of the electives pathway and its interaction with other parts of the New Zealand health system.

In NEAC’s view, there are potential ethical advantages in New Zealand’s ‘booking system’ approach to elective services. To help secure these advantages, however, NEAC considers that the ongoing development of elective services should be more explicitly built around the patient-centred idea of the ‘electives pathway’. This would highlight the full set of steps at which things must work well for patients.

In particular, NEAC wishes to see development of a measure of progress towards the ideal that every patient who has a primary care referral is offered a timely and appropriate specialised service. This is likely also to require ongoing innovation in how, where, and by whom such specialised services are offered.

NEAC considers that there are some issues about the overall design of the electives pathway, and its interaction with other parts of the New Zealand health system, that merit further examination. These issues are:

the ‘first specialist assessment’ step
relations between elective services and acute services
relations between public and private sectors.

Related information

NEAC's Report to the Minister of Health on Ethical Issues in Elective Services.

NEAC commissioned a literature scan report in 2005 to inform its advice to the Minister of Health on elective services: Booking systems for elective services: A literature scan to identify any ethical issues of national significance.